Joanna Klausen Gísladóttir (Nanna) an anaesthetic nurse at SAk has twice been out to help in Gambia and plans to do so once a year in the future: “The project was first to evaluate the work of the staff at the healthcare centre Kubuneh in Gambia and see if there was anything that could be improved. It was a very valuable learning experience and we soon saw that there was something that could be improved even though the staff was doing their best with their education and resources.”

The couple Daði Pálsson and Þóra Hrönn Sigurjónsdóttir from the Westman Islands run the health clinic in Kubuneh in Gambia. Daði is Nanna’s cousin and she has been following the couple since the beginning of the project: “Daði and Þóra are just regular people from the Westman Islands who wanted to do good and they have done it. The health clinic is run by the charity Everyone matters (Allir skipta máli) established by Daði og Þóra. They also run a Kubuneh store in the Westman Islands, which is an impressive circular store. People bring used clothing and items to the store, which are sold and the profit goes to the health clinic in Kubuneh. The store only employs volunteers, Daði and Þóra own the premises and run it themselves, so every króna that comes into the store goes unclaimed to Kubuneh.”

Nanna was very interested in joining them and as a nurse, her education and experience helped her to review her professional work in the healthcare center. Þóra also requested that Nanna bring a doctor along for the trip and it was Arngrímur Vilhjálmsson, Nanna’s GP and friend, who jumped at this unique opportunity. They first went in 2022 for a 10-day trip and last year they went for 2 weeks.

“In the first trip we put forward ideas for an improved procedure and implemented them. The project is constantly evolving, but it’s clear that there are a lot of limitations and obstacles, as the healthcare system in Gambia is very different from what we’re used to. We’re not just trying to teach them out there, we’re also learning a lot because they often have to try improvise with very limited resources,” Nanna says.

No standardized training for nurses in Gambia

There are 284 registered doctors in Gambia, with a population of about 2.5 million. Nurses are more than that, but there is no single standardized training available for nurses, so the knowledge they gain through their education is very different. The healthcare center in Kubuneh has no doctor but three nurses. The healthcare center’s reception area counts 12 - 15.000 people. The nurses work according to clinical guidelines, do checks, attend to injuries and prescribe medications. They then refer patients who they cannot help to larger healthcare centers and hospitals.

“People often have to travel long distances and wait for days for emergency services. There are many people who do not survive. There is a lot of corruption in Gambia at all levels of society and people don’t trust the healthcare system. We have many times had people referred to hospitals for serious illnesses, but people choose not to go. That’s something we don’t know in Iceland. The service can be very costly for people, but what is expensive for the people of Gambia is not a large amount of money for us,” Nanna says.

A normal day in the work of a nurse in a humanitarian aid mission in Gambia

Corruption more than she imagined

Some days included work improving the working environment in the healthcare system, going around the village to visit sponsored children and homes, going into the city to try to get the needed supplies for the healthcare center, and looking at other healthcare facilities. “I thought I was quite prepared before I went to Gambia. I had realized that there is a lot of poverty out there, but it’s still much more noticeable wherever you look or go. It was surprising how much trash is everywhere. It’s very beautiful in Gambia, but where people are - there’s trash. The corruption is also much more than I had imagined. The Gambia state operates hospitals and clinics, but it’s clear that it has very limited funding for their operation and maintenance. There are no medicines, syringes, needles, and even no patches or gauze in these places. Patients come into the healthcare facilities and get a list of what they need to buy to receive treatment. Then patients have to find someone to go to the nearest pharmacy and buy what they need, if they can afford it. The healthcare center in Kubuneh is unique in this country because we make sure that there are always products and medicines that our staff needs to do their job,” Nanna says.

Nanna participated in a program for young girls about sexual development, menstruation and sexual health, which she considers an urgent task. She has also continued to follow up with a patient in Iceland who had a difficult leg ulcer.

“In Gambia I have seen health problems that we almost never see in Iceland and it was amazing to see how other nurses work in need and distress. It was an unique experience and has tought me increased patience, better visualization, increased understanding of different situations of patients; poverty and different religions. There are definitely other factors that follow that make me a better nurse and a better person,” Nanna says.

Good to do good

Nanna says that they are not in danger doing their jobs, but traffic is dangerous: “The locals show us a lot of attention, they follow people and beg. We have managed to explain briefly that we are in Gambia doing humanitarian work and usually it is accepted. We have only had two small incidents where you might we were uncomfortable. We make sure not to travel alone.”

Although she has often experienced feeling powerless over the fact that she could not help everybody who she could easily help in Iceland, she never wanted to give up: “We always feel we do something good, but we need to remind ourselves regularly that we cannot save everyone. You experience all sorts of emotions, whole scale of emotions.”

Incredibly rewarding to participate in such projects

Nanna says it has been difficult to come back home and to leave her people in Kubuneh, the staff at the clinic are not just friends but a family she keeps in touch with when she’s in Iceland. She doesn’t like the feeling of leaving people in unacceptable situations and a bit of hopelessness: “It’s also the driving force, to keep going and improving the situation in the way we can. I have experienced a lot of anger about the healthcare system in Gambia and all this corruption, but my mission is not to defeat that struggle. It’s first and foremost incredibly rewarding to get to take part in such a project, to pass on my knowledge and to experience that I do good in difficult situations. I am very grateful for this opportunity and encourage everyone familiarize themselves with aid work at Everyone matters (Allir skipta máli) in Gambia. They don’t just run the clinic, they are working on a lot of other interesting and important projects in Kubuneh. SAk has, on the other hand, strengthened the project by giving me paid leave from work part of the time I’m in Gambia. It’s incredibly important for the work and we are very grateful for this support.”

Nanna recommends supporting a charity. The charity she works for is certainly a small group that goes together to a small place, but there are many other exciting projects available, such as Doctors Without Borders, the Red Cross and Unicef: “When we were in Gambia last time, we met a Swedish nursing student who was taking her practical training in emergency nursing in Gambia. I encourage health care students to look at the possibilities of an exchange program at their school.”

Facebook: Kubuneh store

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More photos from the trip can be seen on Instagram here.